Millions of people are denied the access to medicines they need because of the high prices set for medicines. STOPAIDS has a history of fighting for and improving patients’ access to affordable medicine. Today, we coordinate the Missing Medicines campaign which aims to tackle high drug prices through strengthening the power of public research and development (R&D) funders and demanding transparency. We also work with the EU Alliance in order to share our learnings and support progress at the European level.
A brief history on HIV and access to medicines
For people living with HIV, the situation regarding getting access to anti-retroviral drugs (ARVs) has changed dramatically over the past 2 decades. In 2000, when the first International AIDS Conference was held on the continent most devastated by the epidemic, only 1000 people living with HIV in Africa had access to ARVs. ARVs were largely available only from originator companies that controlled the patents and ultimately the prices of these medicines, which were set at a hefty US$10,000 – 15000 per patient per year.
Civil society, grassroots AIDS activists and courageous leaders were critical to fighting the exclusivity of branded ARVs and enabling the flow of generic medicines into Africa. Now that generic ARVs are available in Africa for just a few hundred dollars or less per year, there are 18.2 million people living with HIV that have the treatment they need.
The fight for access to medicines has revealed the failures of the patent-driven model which currently dominates medical research and development (R&D). Patents give pharmaceutical companies a 20 year monopoly over a product and therefore the ability to charge whatever price they like. This leads to the decisions and priorities made by pharmaceutical companies being driven by profit rather than public health needs.
As a result, millions of people are missing the drugs they need because they are unaffordable or simply do not exist. To tackle this, STOPAIDS and international civil society have not stopped in demanding and urging governments, corporations and other stakeholders to ensure patients have access to the medicines they need.
STOPAIDS’ work on access to medicines
STOPAIDS have historically been at the forefront of the global access to medicines movement based in the UK. We have campaigned and advocated;
To secure the G8’s landmark commitment to universal access to HIV services in Gleneagles in 2005
For the establishment of the Medicines Patent Pool (MPP) and the involvement of pharmaceutical companies in MPP agreements for ARVs
Against ‘TRIPS plus’ provisions in Free Trade Agreements that threaten access to medicines, including the definition of patentability criteria, patent term extensions, test data protection, that can delay the market entry of generics and increase the price of medicines.
For countries to use TRIPS flexibilities, such as compulsory licensing, freely and without undue pressure from industry or other countries.
For the establishment of the 3P Project, a R&D model that completely delinks the costs of R&D from the final price of the drug
For a global R&D agreement that sets and coordinate global R&D principles and priorities, leverages funding and encourages the use of alternative incentives for R&D.
What we’re currently calling for; Missing Medicines
STOPAIDS coordinates the Missing Medicines coalition of UK-based civil society organisations that seek to change the way medical research and development (R&D) is undertaken in order to secure affordable and appropriate medicines for all who need them.
Industry-led pharmaceutical R&D is incentivised by granting intellectual property rights to the inventor. However, the UK government supports the UK pharmaceutical industry with a variety of incentives including research funding, grants, state facilities and tax credits. In fact 30% of global R&D is financed by the public. Typically, once new medicines are invented, governments grant pharmaceutical companies with the rights to these medicines and trust them to get the drugs on our shelves.
Yet people are being excluded from the fruits of this research both in the NHS and globally, as illustrated in this computer game, Pharmadness. There are many examples, but to illustrate just a few:
Sofosbuvir, a cure for Hepatitis C costs as much as £39,000 per 12 week treatment in Europe. Less than 7% of people with Hepatitis C are able to get this life-saving treatment.
Trastuzumab, a drug to treat secondary breast cancer, costs over £30,000 in South Africa, yet it can be produced for as little as £190 including a reasonable profit. Trastuzumab Emtansine (brand name Kadcyla) was rationed in the UK for years because NICE deemed it too expensive and Roche refused for years to drop the price until recently.
Diabetes supplies in Brazil can be as much as £540 monthly, which is 82% of the average income there.
To avoid high prices, governments need to take control of the research they fund so that all patients can share the benefits. Currently, we don’t know how our public money has contributed to the R&D of medicines and we have no guarantees that public funds will lead to affordable medicines. The UK is the third largest global health R&D funder, after the USA and EU. These commitments include the Ross Fund (including funding for PDPs), the Global Health Challenges Fund and the pharmaceutical components of the Industry Strategy Challenge Fund. Furthermore, the 2017 Conservative manifesto strong supports investments in R&D, with a particular emphasis on health and on investing in our universities.
To prioritise patients, we recommend that the UK implements the following:
- The UK plays a critical role and influence at the global level on R&D and we urge the UK to support the recommendations of the UN High Level Panel on Access to Medicines report, as raised by Virendra Sharma MP in the backbench business debate, ‘Stimulating Research into Infectious Diseases’. Many of these recommendations have been put forward in other reports, including from the WHO’s Consultative Expert Working Group on R&D that DFID directly supported and the report ‘Tackling Drug-Resistant Infections Globally; the Review on Antimicrobial Resistance’. In light of these recommendations, we urge the UK government to consider conducting a feasibility study of de-linking the cost of R&D from the price of the resulting products and providing political and financial support to delinked models.Watch this space for our upcoming report on the role and influence of UK public funding in R&D and for the launch of new campaign actions in September. In the meantime, contact Tabitha (Tabitha@stopaids.org.uk) for more information.
EU Alliance for Affordable Medicines and Responsible R&D
The European Alliance for Responsible R&D and Affordable Medicines is a civil society coalition gathering consumer, patient and public health organisations calling for the creation of an R&D system that is driven by public health needs and delivers medicines that are universally accessible and affordable.
STOPAIDS co-chair the Campaign Working Group alongside Global Health Advocates. The Working Group aims to raise awareness amongst and mobilise the public and decision-makers to take action on the need for guaranteeing a public return on public R&D investment, including the EU research framework programmes. We also facilitate collaboration between members and unify messaging across EU Alliance members that work on the issue of public return on public investment. For more information on the Working Group, please contact Tabitha (Tabitha@stopaids.org.uk)